Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Montana for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Montana only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Montana (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Kalispell Regional Medical Center Inc (NPI 1528386802)

Kalispell Regional Medical Center Inc is a family medicine physician provider located in Polson, Montana. This profile covers 0 Medicare and 10 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Kalispell Regional Medical Center Inc
Address	106 Ridgewater Dr Ste A
City	Polson
State	MT
ZIP	59860
Taxonomy	Family Medicine Physician
NPI Enumerated	May 11, 2010

Payer Source	Total Paid
Medicaid	$418.9K
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	3,740	$60	$213K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	2,610	$70	$187.8K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	190	$40	$7.7K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	130	$20	$2.7K
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	40	$60	$2.6K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	10	$110	$1.3K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	630	$1	$1.3K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	120	$10	$1.2K
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	200	$1	$810
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	10	$40	$590

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Montana providers billing the same CPT/HCPCS codes.

Claims Volume vs. Montana Distribution

Kalispell Regional Medical Center Inc — 0 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. Montana median

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	116	530	580	$70	$224.6K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	120	520	730	$40	$196.4K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	148	160	250	$110	$85.9K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	98	170	310	$20	$38.7K
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	128	190	130	$70	$37.2K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	128	190	390	$10	$19.6K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	227	240	170	$1	$10.3K
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	21	30	1,160	$1	$7.1K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	104	190	950	$1	$4.9K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	97	160	180	$1	$3.5K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Polson Ambulance, Inc.	MT	Land Ambulance	$459.3K	$2.1M
Polson School District 23	MT	Local Education Agency (LEA)	$0	$1.6M
Providence St Joseph Medical Center	MT	Family Medicine Physician	$0	$1.1M
Montana Dental Group LLC	MT	General Practice Dentistry	$0	$1M
Michael Windauer	MT	General Practice Dentistry	$0	$673.1K
Kickin It Enterprises	MT	Clinical Social Worker	$0	$659.3K
Providence St Joseph Medical Center	MT	Critical Access Hospital	$0	$654.7K
Jeffrey Bird	MT	General Practice Dentistry	$0	$619.1K
St Lukes Community Hospital	MT	Rural Health Clinic/Center	$0	$403.3K
Shasta Baum-strait	MT	Mental Health Counselor	$0	$360.7K

Kalispell Regional Medical Center Inc — Billing Profile & Reimbursement Data

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Kalispell Regional Medical Center Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kalispell Regional Medical Center Inc	MT	General Acute Care Hospital	$0	$8.8M
Kalispell Regional Medical Center, Inc	MT	Clinic/Center	$0	$6.2M
Kalispell Regional Medical Center Inc	MT	Psychiatry Physician	$0	$5.9M
Kalispell Regional Medical Center Inc	MT	Emergency Medicine Physician	$0	$5.4M
Kalispell Regional Medical Center Inc	MT	Primary Care Clinic/Center	$0	$4.5M
Kalispell Regional Medical Center Inc	MT	Pediatrics Physician	$0	$3.7M
Applied Health Services Incorporated	MT	Durable Medical Equipment & Medical Supplies	$0	$2.2M
Kalispell Regional Medical Center Inc	MT	Clinic/Center	$0	$2.1M
Kalispell Regional Medical Center Inc	MT	Clinic/Center	$0	$2.1M
Kalispell Regional Medical Center Inc	MT	Neurology Physician	$0	$1.7M